Rechargeable impantable cardioverter defibrillator

ABSTRACT

Rechargeable implantable cardioverter defibrillator including a hermetically sealed can and at least one lead, coupled with the hermetically sealed can, the hermetically sealed can including at least one high voltage capacitor, an electronic circuit, coupled with the high voltage capacitor and a rechargeable battery, coupled with the electronic circuit and the high voltage capacitor, an outer surface of the hermetically sealed can including an active section and a non-active section, the non-active section being electrically insulated from the active section, wherein a surface area of the active section acts as at least one of an electrode with the lead for forming an electric shock vector for applying a high voltage shock and a sensor for sensing electrical activity and wherein a surface area of the non-active section acts as at least one antenna for transmitting and receiving information wirelessly while also receiving electromagnetic energy to inductively charge the rechargeable battery.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of, and priority to, provisionalU.S. patent application serial number 62/159,986, filed May 12, 2015,the entire contents of which are incorporated herein by reference.

FIELD OF THE DISCLOSED TECHNIQUE

The disclosed technique relates to implantable cardioverterdefibrillators (herein abbreviated ICD), in general, and to systems andmethods for constructing and operating rechargeable ICDs, in particular.

BACKGROUND OF THE DISCLOSED TECHNIQUE

An arrhythmia is a medical condition in which there exists a problemwith the rate or rhythm of the heartbeat usually due to abnormalelectrical activity in the heart. More specific types of arrhythmiainclude when the heart beats too fast (known as tachycardia), too slow(known as bradycardia) or with an irregular rhythm (known as cardiacfibrillation). Two general devices are known in the art for helpingpeople who experience arrhythmias. One is known as a pacemaker, theother is known as an implantable cardioverter defibrillator (hereinabbreviated ICD). Pacemakers are implantable devices which continuouslymeasure the heartbeat and electrical activity in the heart. Pacemakerscan detect irregularities in the heartbeat, i.e. arrhythmias, and areprogrammed to provide electrical signals to the heart to restore itsnormal beating rhythm. ICDs are similar to pacemakers and includesimilar components but differ slightly from pacemakers in that theyinclude a power source, electronics, electrical leads as well as atleast one capacitor. The difference between an ICD and a pacemaker isthat an ICD can deliver a high voltage electric shock to the heart toterminate an otherwise potentially fatal cardiac tachyarrhythmia, suchas ventricular fibrillation (herein abbreviated VF). A pacemaker isgenerally limited to treating less severe arrhythmias such asbradyarrhythmias which can be treated with a significantly lower voltageelectric impulse. The presence of at least one high voltage capacitor inan ICD accounts for its difference in function from a pacemaker as theat least one high voltage capacitor enables a significantly highervoltage electrical shock to be built up and delivered as higher voltageenergy to the heart. In the case of VF, the function of an ICD is tosend the heart an electrical shock in order to prevent cardiac arrest,i.e., aborted sudden death; this is highly important and could be amatter of life or death. The electrical energy required for theelectrical shock is built up and stored in the at least one high voltagecapacitor. ICDs exist as standalone devices yet are also manufacturedhaving the functionality of a pacemaker. In addition, cardiacresynchronization therapy defibrillators (herein abbreviated as CRT-D),which are similar to ICDs, may include an additional electrode to enablesimultaneous pacing of both the right and left ventricles of the heart.

Reference is now made to FIG. 1A, which is a schematic illustration ofan ICD implanted in a patient, generally referenced 10, as is known inthe art. As shown in FIG. 1A, an ICD 12 is implanted in a patient 14,having a heart 16 and a ribcage 18. ICD 12 includes two main components,a single can 20 and electrical leads 22. Can 20 can also be referred toas a canister or housing. Can 20 includes a power source (not shown),such as a battery, a high voltage capacitor, as well as an electroniccircuit (not shown) for monitoring the electrical activity in the heartand for providing electrical signals to the heart when aberrant rhythmsof the heart are detected. Can 20 is usually implanted in patient 14 viaa surgical procedure on his left side adjacent to and below the claviclebone (also known as the collarbone), as shown by an arrow 24 in FIG. 1A.Electrical leads 22 are coupled with the electronic circuit in can 20 atone end and are coupled with heart 16 at the other end, the electricalleads being inserted through the subclavian vein (not shown) and thevena cava (not shown). Electrical leads 22 are typically implanted inpatient 14 by inserting them percutaneously through his vena cava (notshown) and into heart 16. Once attached to heart 16, they are coupledwith can 20. Electrical leads 22 are usually flexible and provideelectrical signals of heart 16 to the electronic circuit in can 20 andare used to deliver a high voltage and high energy shock from theelectronic circuit to heart 16 in the case of VF. Typically, electricalleads 22 are implanted in right ventricle 26 and right atrium 28 ofheart 16.

As mentioned above, ICDs, similar to pacemakers, constantly monitor therate and rhythm of the heart and deliver therapies to the heart by wayof an electrical shock. In the case of an ICD, electrical shocks areprovided to the heart when the measured electrical activity of the heartexceeds a preset number. State of the art ICDs can distinguish differenttypes of aberrant electrical activity in the heart, such as VF, when theheart contracts irregularly, versus ventricular tachycardia (hereinabbreviated VT), when the heart beats regularly but significantly fasterthan normal. In the case of VT, such ICDs may send electrical signals tothe heart to try and pace the heart faster than its intrinsic heart ratein an attempt to stop the tachycardia before it progresses to VF. Thistechnique is known in the art as fast-pacing, overdrive pacing oranti-tachycardia pacing (herein abbreviated ATP). As is known to workersskilled in the art, ATP is only effective if the underlying rhythm ofthe heart is ventricular tachycardia. State of the art ICDs use acombination of various methods to determine if received electricalsignals from the electrical leads represent a normal rhythm of theheart, ventricular tachycardia or ventricular fibrillation. It is notedthat the placement of an ICD in the body of a patient is similar to thatof a pacemaker, however in the case of a CRT-D device, the electricalleads can also be implanted in the left side of the heart via thecoronary sinus (not shown) of the heart. This is shown in FIG. 1A as anelectrical lead 30, denoted by a dashed line. In addition, is it notedthat state of the art ICDs exist in which the electrical leads of an ICDare not inserted into the heart but are positioned subcutaneously aboveor around the heart. This is shown below in FIGS. 1B and 1D. Such ICDsprovide improved safety to a patient since the insertion of theelectrical leads of the ICD does not involve any intervention with theheart.

Pacemakers and ICDs with intravascular leads, as shown in FIG. 1A, areadvantageous in that the electrical leads used for sensing arrhythmiasas well as delivering electrical shocks and impulses to the heart areplaced directly in the heart (i.e., hence intravascularly). Such aplacement of the electrical leads allows for a significantly highsignal-to-noise ratio (herein abbreviated SNR) such that aberrantelectrical activity detected in the heart is in fact aberrant electricalactivity of the heart and not electrical activity coming from anothersource of electrical activity in the body near the heart or from asource outside the body generating an electric field. Also, thecloseness of the electrical leads to the chambers of the heart enables agenerally lower voltage to be applied to the heart for either pacing itor for treating VT or VF via high voltage electrical shocks. Suchpacemakers and ICDs however are disadvantageous in that major surgery isrequired to implant the can in the body and the electrical leads in thevasculature of the heart. This disadvantage is true of intravascularICDs as well as the entire device must be implanted in the vasculatureof the patient. Furthermore, when the energy of the battery is depleted,or if there is a problem with the electrical leads placed in the heart,the patient must undergo further surgery to either replace the entirecan or to have new electrical leads placed in the heart. Pacemakers andICDs having cans with replaceable and/or rechargeable batteries arecurrently not on the market, thus when the battery of such devices isdepleted, the entire can of the device (pacemaker or ICD) must bereplaced.

In the past decade, there has been a general trend in surgery andimplantable medical devices to reduce the amount of invasiveness ofeither the surgery involved or the positioning of the implantablemedical device in the body of a patient. For example, in the field ofICDs, medical device companies have begun researching and developingsubcutaneous ICDs which are to be placed under the skin and around theheart, thereby significantly reducing the invasiveness of an implantingprocedure and the actual positioning of the ICD in the body of thepatient. One of the reasons for this trend in ICDs is that manyhealth-related issues have occurred with the intravascular andintracardiac leads used in prior art ICDs, including the recall of suchleads. Intravascular and intracardiac leads move a tremendous amountwithin the heart as it beats during the lifespan of a prior art ICD.With an average of 70 movements per minute over the course of sevenyears, an intravascular lead may move over 250 million times. Theseleads thus require a very high durability due to the continuous movementof these leads within the heart and can wear and break over time,causing serious problems to the patient, including patient death. Majorcompanies in this field include Boston Scientific, Cameron Health(acquired by Boston Scientific), Medtronic and St. Jude Medical. Ofthese companies, only Cameron Health has an actual subcutaneous ICDdevice in the market.

Reference is now made to FIG. 1B, which is a schematic illustration of afirst subcutaneous ICD implanted in a patient, generally referenced 40,as is known in the art. A patient 44 is shown, having a heart 46 and aribcage 48. A subcutaneous ICD 42 in placed under the skin near theheart. Subcutaneous ICD 42 includes a can 50 and 10 electrical leads 52,each respectively similar to can 20 (FIG. 1A) and electrical leads 22(FIGS. 1A). Can 50 can also be referred to as a canister. Can 50 isusually positioned under the skin around a fifth left rib 51, near theheart (i.e., laterally to the heart), whereas electrical leads 52 arepositioned around heart 46. Usually a first electrical lead ispositioned anterior to heart 46 whereas a second electrical lead ispositioned posterior to heart 46, thus creating an electrical shockvector between the two electrical leads via heart 46. Subcutaneous ICD42 thus also has a can and leads configuration, similar to pacemaker 10(FIG. 1A).

Subcutaneous ICD 42 is advantageous over an ICD with intravascular leadsand an intravascular ICD in that major surgery is not involved in itsplacement and improved safety is provided to the patient since theinsertion of the electrical leads of the ICD does not involve anyintervention with the heart or puncturing of a blood vessel. Replacingcan 50 or replacing electrical leads 52 if they are faulty is alsosimpler in that only percutaneous surgery is involved. However, sincesubcutaneous ICD 42 and its electrical leads are not placed in thevasculature of the heart, electrical leads 52 may have a significantlylower SNR and thus the electric circuit (not shown) in can 50 may have aharder time differentiating between electrical activity of the heart andwhat is known in the field as extra-cardiac oversensing or extra-cardiacnoise (i.e., electrical activity sensed from non-cardiac muscles aroundthe heart and electrical activity coming from sources outside thepatient). This difficulty in differentiating between true electricalactivity of the heart and extra-cardiac oversensing can lead tosubcutaneous ICD 42 delivering shocks to the heart when it doesn't needit and also failing to deliver shocks to the heart when it does need it.In addition, since electrical leads 52 are not placed directly in heart46, a higher voltage must be applied to the leads for treating VT or VFvia electrical shocks as compared with conventional ICDs (as in FIG. 1A)in which its leads are placed intravascularly directly in the heart. Thehigher voltage requires a higher level of energy. The higher level ofenergy thus requires a larger can volume since the can requires a largerbattery and larger high voltage capacitors to provide the higher energyrequirements. The can and leads configuration of subcutaneous ICD 42 mayalso cause discomfort to patient 44, especially considering that therigid outer surface of can 50 is placed directly on ribcage 50 wherehumans in general do not have a lot of excess skin or fat tissue in thisparticular region of the body to cushion can 50. A further disadvantageof a subcutaneous ICD is that due to its placement in a patient, manysensory and motor nerves are located between the electrical leads. Anystimulation generated between the electrical leads for the heart will befelt by the patient as both muscle contractions (i.e., from the motornerves) and pain (i.e., from the sensory nerves). This is much less of aconcern for an ICD with intracardiac leads, especially when stimulationis generated between the leads in the heart, as the electric fieldgenerated is essentially limited to the area of the heart and does notcause muscle contractions or the sensation of pain around the heart. Ifit for this reason that subcutaneous ICDs generally do not provide apacing function.

Some of the concerns with subcutaneous ICD 42 have been mitigated bymedical device companies using a different configuration forsubcutaneous ICDs, such as a curved configuration. Reference is now madeto FIG. 1C, which is a schematic illustration of a second subcutaneousICD implanted in a patient, generally referenced 60, as is known in theart. A patient 64 is shown having a heart 66 and a ribcage 68. Asubcutaneous ICD 62 in placed under the skin near the heart.Subcutaneous ICD 62 includes a housing 63. Housing 63 includes aplurality of surface electrodes 70, an electric circuit (not shown), abattery (not shown) and at least one high voltage capacitor (not shown),similar to the elements found in subcutaneous ICD 42 (FIG. 1B). Housing63 has a curved configuration, being thin, narrow and flexible, similarto a patch, bandage or plaster and shaped to fit around a patient's rib.Plurality of surface electrodes 70 are positioned on one side of housing63, giving subcutaneous ICD 62 a specific directionality. As shown inFIG. 1C, a first surface electrode 72A and a second surface electrode72B are placed on an inner side of housing 63, facing towards the body(not labeled) of patient 64. As compared with subcutaneous ICD 42,subcutaneous ICD 62 does not have any electrical leads. Instead firstsurface electrode 72A and second surface electrode 72B are used to bothsense electrical activity of heart 66 as well as apply electrical shocksto heart 66. Plurality of surface electrodes 70 thus function aselectrical leads.

Housing 63 is usually positioned under the skin around a fifth left rib74, near the heart. Since housing 63 is flexible, it is usually wrappedaround fifth left rib 74, or near it, following the contours of ribcage68 and partially wrapping around heart 66. A proximal end (not labeled)of housing 63 may be anterior to heart 66 and a distal end (not labeled)of housing 63 may be posterior to heart 66. An electrical shock vectoris thus created between plurality of surface electrodes 70 via heart 66.It is noted that housing 63 is usually made of metal and can alsofunction as a sensor or electrical lead. Housing 63 is thus alsoreferred to in the art as an active can. In such a configuration, one ofthe surface electrodes can be used to sense electrical activity whereasthe other surface electrode can be used with housing 63 to create anelectrical shock vector. Subcutaneous ICDs having a curved configurationare known in the art, such as U.S. Pat. No. 6,647,292 B1 to Bardy etal., assigned to Cameron Health, entitled “Unitary subcutaneous onlyimplantable cardioverter-defibrillator and optional pacer.” Otherexamples include the following patents: U.S. Pat. No. 7,363,083 B2, U.S.Pat. No. 8,718,760 B2 (all assigned to Cameron Health Inc.) and U.S.Pat. No. 7,684,864 B2 (assigned to Medtronic Inc.).

Whereas subcutaneous ICD 62 may be more comfortable for a patient thansubcutaneous pacemaker 42 (FIG. 1B) due to its flexible thin shape andslightly reduced invasiveness since only a single element needs to beimplanted in patient 64, surgery is still required to replace a deadbattery in subcutaneous ICD 62. In addition, subcutaneous ICD 62 maysuffer the same SNR issues that accompany subcutaneous ICD 42 in termsof differentiating true cardiac electrical activity compared toextra-cardiac oversensing. In addition, as mentioned above subcutaneousICD 62 has a particular directionality and must be placed in a specificorientation to function properly in patient 64.

Reference is now made to FIG. 1D, which is a schematic illustration of athird subcutaneous ICD implanted in a patient, generally referenced 80,as is known in the art. A patient 84 is shown, having a heart 86 and aribcage 88. A subcutaneous ICD 82 in placed under the skin just outsideribcage 88 near the heart. Subcutaneous ICD 82 includes a can 89 and anelectrical lead 91, each respectively similar to can 20 (FIG. 1A) andelectrical leads 22 (FIGS. 1A). Can 89 and electrical lead 91 arecoupled by a wire 90. Electrical lead 91 is positioned over a sternum 92of ribcage 88, anterior to heart 86. Can 89 is an active can andsubstantially acts as an electrode and secondary electrical lead. Anelectrical shock vector can thus be generated between can 89 andelectrical lead 91. Like in FIG. 1B, subcutaneous ICD 82 has a can andleads configuration, similar to ICD 12 (FIG. 1A). Subcutaneous ICDshaving a can and leads configuration are known in the art, such asdescribed in U.S. Pat. No. 6,721,597 B1 to Bardy et al., assigned toCameron Health, Inc., entitled “Subcutaneous only implantablecardioverter defibrillator and optional pacer.” Other examples includethe following patents and patent applications: U.S. Pat. No. 8,483,841B2, U.S. Pat. No. 8,644,926 B2 (all assigned to Cameron Health Inc.),U.S. Pat. No. 8,260,415 B2, U.S. Pat. No. 8,512,254 B2, U.S. Pat. No.8,359,094 B2, U.S. Pat. No. 7,894,894 B2 (all assigned to MedtronicInc.) and EP 2 510 973 A1 (applicant Cardiac Pacemakers Inc.).

In general each one of cans 20 (FIG. 1A), 50 (FIG. 1B) and 89 (FIG. 1D)is made from metal and is hermetically sealed to prevent bodily fluidsfrom entering therein. The cans thus form Faraday cages. In some priorart ICDs as explained above, the can is an active can, meaning it canconduct electricity and can be used in conjunction with at least oneelectrical lead for generating a shock vector through the heart. In FIG.1A for example, this is shown schematically via an arrow 32. On themarket ICDs are generally one time use devices in that when their powersource, such a battery, is diminished, the can of the device whichhouses the battery must be completely replaced. Since replacing the canrequires surgery to remove the old can and insert a new can, there is adesire to minimize the number of times the can must be replaced over thelifetime of a patient as surgical intervention increases variousassociated risks (e.g., infection, muscle tissue weakening and thelike). In this respect, ICDs are designed with power sources largeenough to last on average between 5-7 years in a patient. Since thepower source substantially provides electrical charge, mostsignificantly for dealing with VT and VF, there is a direct correlationbetween the size of an ICD and the amount of charge its battery canstore. An increase in battery life of the can is thus directlycorrelated to an increase in physical size of the ICD, in order toaccommodate a large enough power source to last 5-7 years. It is notedthat the actual length of time an ICD lasts depends on each particularpatient and the actual activity of their heart. An ICD in general storesenough electrical charge to provide around 100 to possibly 200electrical shocks for dealing with VT and VF. Therefore an ICD may lastless than or more than 5-7 years depending on how frequently the ICDmust provide high energy electrical shocks when dealing with arrhythmiasof the heart of the patient.

ICDs are known in the art as previously mentioned. Further examplesinclude ICDs as disclosed in the following U.S. patents and publishedU.S. patent applications: U.S. Pat. No. 7,389,138 to Wagner et al., U.S.Pat. No. 7,792,588 to Harding, U.S. Pat. No. 7,991,467 to Markowitz etal., U.S. Pat. No. 8,290,593 to Libbey et al., U.S. Pat. No. 8,452,404to Fischell et al., U.S. Pat. No. 8,700,174 to Skelton et al., US2002/0013613 to Haller et al., US 2004/0172066 to Wagner et al., US2008/0183247 to Harding, US 2011/0093051 to Davis et al., US2011/0106200 to Ziegler et al., US 2012/0276856 Joshi et al. and US2014/0304773 to Woods et al.

SUMMARY OF THE DISCLOSED TECHNIQUE

It is an object of the disclosed technique to provide a novel method andsystem for a rechargeable ICD which includes at least one antenna andwhich can be recharged wirelessly. In accordance with the disclosedtechnique, there is thus provided a rechargeable ICD including ahermetically sealed can and at least one lead. The hermetically sealedcan includes at least one high voltage capacitor, an electronic circuitand a rechargeable battery. The outer surface of the hermetically sealedcan includes an active section and a non-active section. The lead iscoupled with the hermetically sealed can. The electronic circuit iscoupled with the high voltage capacitor and the rechargeable battery iscoupled with the electronic circuit and the high voltage capacitor. Thenon-active section is electrically insulated from the active section. Asurface area of the active section acts as at least one of an electrodewith the lead for forming an electric shock vector for applying a highvoltage shock and a sensor for sensing electrical activity. A surfacearea of the non-active section acts as at least one antenna fortransmitting and receiving information wirelessly while also receivingelectromagnetic (EM) energy to inductively charge the rechargeablebattery.

In accordance with another aspect of the disclosed technique, there isthus provided a rechargeable ICD including a hermetically sealed can andat least one lead. The hermetically sealed can includes at least onehigh voltage capacitor, an electronic circuit and a rechargeablebattery. An outer surface of the hermetically sealed can includes anactive section, a non-active section and an isolator. The lead iscoupled with the hermetically sealed can. The electronic circuit iscoupled with the high voltage capacitor and the rechargeable battery iscoupled with the electronic circuit and the high voltage capacitor. Theisolator is coupled with the active section and the non-active sectionand is for electrically insulating the active section from thenon-active section. A surface area of the active section acts as atleast one of an electrode with the lead for forming an electric shockvector for applying a high voltage shock and a sensor for sensingelectrical activity. A surface area of the non-active section acts as atleast one antenna for transmitting and receiving information wirelesslywhile also receiving EM energy to inductively charge the rechargeablebattery.

In accordance with a further aspect of the disclosed technique, there isthus provided a rechargeable ICD including an active section and anon-active section. The active section includes at least one highvoltage capacitor, an electronic circuit and a rechargeable battery. Theelectronic circuit is coupled with the high voltage capacitor and therechargeable battery is coupled with the electronic circuit and the highvoltage capacitor. The non-active section is electrically insulated fromthe active section and forms a hermetically sealed can with the activesection. A surface area of the active section acts as at least one of anelectrode for forming an electric shock vector for applying a highvoltage shock and a sensor for sensing electrical activity. A surfacearea of the non-active section acts as at least one antenna fortransmitting and receiving information wirelessly while also receivingEM energy to inductively charge the rechargeable battery.

In accordance with another aspect of the disclosed technique, there isthus provided a rechargeable ICD including a hermetically sealed can andat least one lead. The hermetically sealed can includes at least onehigh voltage capacitor, an electronic circuit, a rechargeable batteryand at least one antenna. The lead is coupled with the hermeticallysealed can. The electronic circuit is coupled with the high voltagecapacitor and the rechargeable battery is coupled with the electroniccircuit and the high voltage capacitor. The antenna can wirelesslyreceive EM energy for inductively charging the rechargeable battery. Theantenna can wirelessly transmit signals indicative of a status of therechargeable ICD to an external device and can wirelessly receivesignals from a programmer for programming the electronic circuit.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosed technique will be understood and appreciated more fullyfrom the following detailed description taken in conjunction with thedrawings in which:

FIG. 1A is a schematic illustration of an ICD implanted in a patient, asis known in the art;

FIG. 1B is a schematic illustration of a first subcutaneous ICDimplanted in a patient, as is known in the art;

FIG. 1C is a schematic illustration of a second subcutaneous ICDimplanted in a patient, as is known in the art;

FIG. 1D is a schematic illustration of a third subcutaneous ICDimplanted in a patient, as is known in the art;

FIG. 2A is a schematic illustration of a rechargeable ICD, constructedan operative in accordance with an embodiment of the disclosedtechnique;

FIG. 2B is a see-through schematic illustration of the rechargeable ICDof FIG. 2A, constructed an operative in accordance with anotherembodiment of the disclosed technique;

FIG. 3 is a schematic illustration of the internal components of therechargeable ICD can of FIG. 2A, constructed and operative in accordancewith a further embodiment of the disclosed technique;

FIG. 4A is a schematic illustration of the rechargeable ICD of FIG. 2Acommunicating with a smartphone, constructed and operative in accordancewith another embodiment of the disclosed technique;

FIG. 4B is a schematic illustration of the rechargeable ICD of FIG. 2Acommunicating with a charger transmitter/programmer, constructed andoperative in accordance with a further embodiment of the disclosedtechnique;

FIG. 5 is a schematic illustration showing a difference in size betweenthe ICDs of FIGS. 1A, 1B and 1D and the rechargeable ICD of FIG. 2A,constructed an operative in accordance with another embodiment of thedisclosed technique;

FIG. 6A is a schematic illustration another rechargeable ICD,constructed an operative in accordance with a further embodiment of thedisclosed technique; and

FIG. 6B is a schematic illustration a further rechargeable ICD,constructed an operative in accordance with another embodiment of thedisclosed technique.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The disclosed technique overcomes the disadvantages of the prior art byproviding a novel rechargeable ICD which includes at least one internalantenna and which can be recharged wirelessly. The rechargeable ICD canis designed to encapsulate a relatively small battery, thussignificantly reducing the size of the can of the ICD. However since thesmall battery can be recharged, even though less electrical charge isstored on the battery, due to its ability to be recharged, the life spanof the novel rechargeable ICD can be as much as two to three times aslong as current prior art non-rechargeable ICDs. The at least oneantenna of the disclosed technique enables the rechargeable ICD tocommunicate information about itself to a portable user device, such asa smartphone or tablet computer. The at least one antenna also enablesthe rechargeable ICD to receive energy and charge the battery in the caninductively and thus wirelessly. The energy used to recharge the batteryin the ICD can be modulated such that a wireless programmer can be usedby a physician to program the rechargeable ICD while the rechargeableICD is being recharged. In one embodiment of the disclosed technique,the can of the rechargeable ICD has an active section and a non-activesection. The active section enables the can of the rechargeable ICD tobe used as an electrode for creating a high voltage electric shockvector through the heart of a patient. The non-active section enablesenergy and signals to be transferred wireless to and from therechargeable ICD without interference while nevertheless keeping ahermetically sealed rechargeable ICD can.

It is noted that the disclosed technique relates to any ICDconfiguration having a single can and at least one lead in which the canacts as an electrode and in conjunction with the at least one lead isused to generate a high voltage electrical shock vector through theheart. Thus any ICD configuration in which the single can includes allthe necessary components for functioning as an ICD, such as a powersource, at least one high voltage capacitor and an electronic circuit,such as a processor, is applicable to the disclosed technique. Inaddition, the at least one lead can be placed intravascularly (i.e.,within the heart) or nonvascularly (i.e., external to the heart), suchas subcutaneously or percutaneously around the heart. It is also notedthat in describing the ICD of the disclosed technique, the term “can”can also refer to the terms “canister,” “housing,” “compartment” or“body.”

Reference is now made to FIG. 2A, which is a schematic illustration of arechargeable ICD, generally referenced 100, constructed an operative inaccordance with an embodiment of the disclosed technique. RechargeableICD 100 has the general look of known ICDs and includes a can 101 and atleast one lead 106. Can 101 encapsulates all the necessary componentsfor an ICD to function as an ICD, including a power source such as arechargeable battery (not shown), at least one high voltage capacitor(not shown) and an electronic circuit (not shown), such as a processor.Can 101 also includes at least one antenna (not shown) and a chargingcircuit (not shown). Can 101 includes an active portion 102 and anon-active portion 104. Active portion 102 forms the bulk of can 101 andin general encapsulates the rechargeable battery, the at least one highvoltage capacitor, the charging circuit and the electronic circuit.Non-active portion 104 may encapsulate the at least one antenna. Atleast one lead 106 is coupled with can 101 via non-active portion 104,as shown in FIG. 2A, although at least one lead 106 may also be coupledwith active portion 102 via a dielectric feed-thru (not shown).Rechargeable ICD 100 may include a plurality of leads, depending on itsfunctioning. For example, as a pacemaker, only one lead may be necessaryyet as a CRT-D, three leads may be necessary. At least one lead 106includes a shocking coil (not shown) for providing an electrical shockand at least one sensor (not shown) for sensing electrical activity ofthe heart (not shown). Active portion 102 is a hermetically sealed metalcan and substantially acts as an electrode thus enabling a high voltageshock vector to be formed between active portion 102 and at least onelead 106. Active portion 102 can also act as a sensor for sensingelectrical activity of the heart. Active portion 102 is active in thatit can conduct electricity and substantially forms a Faraday cage.Non-active portion 104 is not active and thus does not form a Faradaycage and therefore enables electromagnetic (herein abbreviated EM)signals to pass there through. Non-active portion 104 may be made froman insulating material such as glass, ceramic or porcelain and iselectrically insulated from active portion 102. It is noted thatnon-active portion 104 can be placed anywhere on the outer surface ofactive portion 102 and not just in the configuration as shown in FIG.2A. In addition, non-active portion 104 can take up any portion of thesurface area of active portion 102. Non-active portion 104 does not actas an electrode in conjunction with at least one lead 106 like activeportion 102 does and is thus transparent to electromagnetic energy.Non-active portion 104 does not create a Faraday cage in contrast toactive portion 102, which is substantially a metal can.

Reference is now made to FIG. 2B, which is a see-through schematicillustration of the rechargeable ICD of FIG. 2A, generally referenced120, constructed an operative in accordance with another embodiment ofthe disclosed technique. Rechargeable ICD 120 is shown without the leastone lead to keep the figure simple and not cluttered. As shown, the can(not labeled) of rechargeable ICD 120 includes an active portion 122 anda non-active portion 124. Active portion 122 is colored with hatchedlines indicating that it is active and can conduct electricity.Non-active portion 124 is not active and thus does not conductelectricity. Since active portion 122 is made from metal and is active,non-active portion 124 must be insulated from active portion 122otherwise it too may become active. As shown, an insulator 126 is placedbetween active portion 122 and non-active portion 124 to electricallyinsulate non-active portion 124 from active portion 122. Insulator 126can be made from glass, porcelain, ceramic or other known insulatormaterials. Shown as well in FIG. 2B is at least one antenna 128, locatedwithin non-active portion 124. At least one antenna 128 is internal tothe can of rechargeable ICD 120, thus enabling the outer surface ofrechargeable ICD 120 to remain a smooth, simple shape. In addition, atleast one antenna 128 can transmit and receive signals from withinnon-active portion 124 since non-active portion 124 is not active anddoes not form a Faraday cage.

Reference is now made to FIG. 3, which is a schematic illustration ofthe internal components of the rechargeable ICD can of FIG. 2A,generally referenced 140, constructed and operative in accordance with afurther embodiment of the disclosed technique. As shown, rechargeableICD can 140 includes a non-active portion 142, an active portion 144 andan insulator 146. Non-active portion 142 is not active and insulator 146electrically insulates non-active portion 142 from active portion 144.It is noted that insulator 146 may form a part of non-active portion 142and may be a glass or ceramic compartment forming non-active portion142. Non-active portion 142 includes a transmission antenna 148A, aninduction antenna 148B and at least one lead connection (not shown).Active portion 144 includes an electronic circuit 150, a rechargeablebattery 152, a charging circuit 153 and at least one high voltagecapacitor 154. Rechargeable battery 152 is coupled with electroniccircuit 150, charging circuit 153 and at least one high voltagecapacitor 154. At least one high voltage capacitor 154 is coupled withelectronic circuit 150. Charging circuit 153 is also coupled withrechargeable battery 152. Transmission antenna 148A is coupled withelectronic circuit 150 via a dielectric feed-thru 156. Induction antenna148B is coupled with charging circuit 153 and electronic circuit 150 viadielectric feed-thru 156. Charging circuit 153 is coupled withdielectric feed-thru 156. At least one high voltage capacitor 154 andelectronic circuit 150 are coupled with a lead (not shown) viadielectric feed-thru 156. Dielectric feed-thru 156 enables a pluralityof wires 158 from transmission antenna 148A, induction antenna 148B andthe at least one lead connection to couple with a plurality of wires 160from electronic circuit 150, at least one high voltage capacitor 154 andcharging circuit 153 while maintaining the hermetic seal of non-activeportion 142 and active portion 144 and the electrical insulation asprovided by insulator 146. The at least one lead connection (not shown)is for coupling the at least one lead (not shown) of the rechargeableICD with rechargeable ICD can 140. As mentioned above, the at least onelead connection could be positioned in active portion 144 via anotherdielectric feed-thru (not shown).

It is noted that electronic circuit 150 can be embodied as a processor.At least one high voltage capacitor 154 is provided with charge viarechargeable battery 152. Electronic circuit 150 receives informationabout the electrical activity of the heart (not shown) via the lead. Ifan arrhythmia is detected, then electronic circuit 150 provides a signalto at least one high voltage capacitor 154 to discharge and provide anelectric shock via the lead to the heart. As mentioned above, theelectric shock vector is provided between the lead and active portion144 which acts as an electrode. Induction antenna 148B can transmit andreceive signals whereas transmission antenna 148A can only transmitsignals. In another embodiment of the disclosed technique, transmissionantenna 148A and induction antenna 148B are embodied as a singleantenna. Transmission antenna 148A can transmit signals from electroniccircuit 150 to an external device (not shown), such as a smartphone ortablet computer, to provide diagnostic information about rechargeableICD can 140 to a user. Induction antenna 148B can transmit signals to aprogrammer (not shown) for providing diagnostic information aboutrechargeable ICD can 140 to a physician, such as a cardiologist orelectrophysiologist. Induction antenna 148B can also receive signals.Induction antenna 148B can receive EM energy, for example in the form ofradio frequency (herein abbreviated RF) energy. The received energy ispassed to charging circuit 153 which converts the RF energy intoelectrical energy that can be used to inductively recharge rechargeablebattery 152. Induction antenna 148B can also receive signals from theprogrammer, which are passed to electronic circuit 150, to changesettings and the functioning of rechargeable ICD can 140.

Rechargeable battery 152 can be any known rechargeable battery as usedin medical devices, such as a lithium-ion battery. Since rechargeablebattery 152 can be recharged, rechargeable battery 152 can be physicallysmaller and designed to only hold enough electrical charge to charge atleast one high voltage capacitor 154 around twenty times and to maintainthe functionality of rechargeable ICD can 140 during electrical shocksand between electrical shocks. This may result in rechargeable ICD can140 being substantially smaller than other ICD cans. In addition, sincerechargeable battery 152 can be recharged multiple times, for examplehundreds of charge-discharge cycles, rechargeable ICD can 140 may beable to provide up to hundreds of electrical shocks before rechargeablebattery 152 can no longer be recharged. Therefore according to thedisclosed technique a smaller sized battery, which is rechargeable, canbe used in an ICD can in order to significantly extend the lifespan ofthe rechargeable ICD. An immediate benefit of such an ICD is that thenumber of times the rechargeable ICD can needs to be replaced issubstantially reduced as compared with known ICD cans that are replacedevery 5-7 years. According to the disclosed technique, rechargeable ICDcan 140 may need to be replaced every 10-15 years.

Reference is now made to FIG. 4A, which is a schematic illustration ofthe rechargeable ICD of FIG. 2A communicating with a smartphone,generally referenced 180, constructed and operative in accordance withanother embodiment of the disclosed technique. As in FIGS. 2B and 3, theat least one lead of the rechargeable ICD is not shown so as to keep thefigure less cluttered. As shown, a rechargeable ICD can 182 cancommunicate signals wirelessly to an external device 184. Externaldevice 184 may be a smartphone, tablet computer, personal digitalassistant and the like. External device 184 is a user device. As shown,wireless signals 186 are transmitted from a non-active portion 190 ofrechargeable ICD can 182. Wireless signals 186 can be transmitted usingknown wireless protocols such as Bluetooth®, Bluetooth low energy(BLE®), Wi-Fi®, Medical Implant Communication Service (MICS), MedicalImplant Communication Service Medical Data Service (MICS/MEDS), MedicalDevice Radiocommunications Service (MedRadio) and the like. Externaldevice 184 may belong to the patient or a relative of the patient. Asshown by an arrow 188, communication from rechargeable ICD can 182 toexternal device 184 is unidirectional. This may be for security purposesto not compromise control of the processor (not shown) in rechargeableICD can 182, which may only be modified or given instructions via aunique programmer (not shown) which may be located at the office of thephysician of the patient. External device 184 may include an application(not shown) for displaying various parameters of the rechargeable ICD.The information provided to external device 184 may include statusindicators of the rechargeable ICD as well as data about the patientgarnered from a sensor (not shown) on a lead (not shown) of therechargeable ICD. As mentioned above in FIG. 3, a dedicated antenna inthe rechargeable ICD of the disclosed technique may be used solely fortransmitting and communicating status information to a patient viawireless protocols such as BLE®, Wi-Fi® or other known wirelesscommunication methods.

Reference is now made to FIG. 4B, which is a schematic illustration ofthe rechargeable ICD of FIG. 2A communicating with a chargertransmitter/programmer, generally referenced 220, constructed andoperative in accordance with a further embodiment of the disclosedtechnique. As in FIG. 4A, the at least one lead of the rechargeable ICDis not shown so as to keep the figure less cluttered. As shown, arechargeable ICD can 222 can communicate signals wirelessly with acharger transmitter/programmer 226. Charger transmitter/programmer 226is a physician's device for inductively charging the rechargeable ICD aswell as providing instructions and signals for modifying and programmingthe processor (not shown) of the rechargeable ICD. As shown, high energywireless signals 230 and 234 are transmitted from and received to anon-active portion 224 of rechargeable ICD can 222. High energy wirelesssignals are required in order to recharge the battery of therechargeable ICD quickly and efficiently. Wireless signals 230 and 234can be transmitted using known high energy wireless protocols such as RFenergy and the like. As shown by arrows 228 and 232, communication fromrechargeable ICD can 222 to charger transmitter/programmer 226 isbidirectional. Charger transmitter/programmer 226 can transmit energy toinductively charge the battery (not shown) in rechargeable ICD can 222.The energy used to recharge the battery can also be modulated. Themodulated signals can thus be used to transmit programming instructionsto the processor (not shown) in rechargeable ICD can 222. Likewise,rechargeable ICD can 222 can transmit diagnostic information to chargertransmitter/programmer 226 which a physician can use to determine ifchanges need to be made to the functioning of rechargeable ICD can 222via its processor (not shown). The diagnostic information can includeelectrocardiogram information about the patient's heart, other monitoredparameters of the patient's heart gathered from the sensor (not shown)on the at least one lead (also not shown) of the rechargeable ICD, aswell as information about the rechargeable ICD such as how manyelectrical shocks were delivered over the past year, how much charge isleft on the battery, when charging is required and the like.

It is noted that the rechargeable ICD of the disclosed technique isdesigned to store about twenty electrical shocks, which should besufficient for a year's worth of functioning. In this respect, therechargeable ICD of the disclosed technique is to be recharged once ayear. The battery of the rechargeable ICD can be recharged at aphysician's office in about an hour, thus not tremendouslyinconveniencing a patient having such an ICD in their heart. It is alsonoted that charger transmitter/programmer 226 may include a touchscreen(not shown) or a plurality of buttons (not shown) for programming therechargeable ICD.

It is further noted that as mentioned above, the rechargeable ICD of thedisclosed technique includes an active portion and a non-active portion.According to a preferred embodiment of the disclosed technique, when therechargeable ICD is implanted inside a patient, whether it be near theclavicle bone, around the fifth rib in the ribcage or adjacent to theribcage, or any other position in the thoracic region of the patient,the active portion of the rechargeable ICD should be placed proximal tothe heart of the patient whereas the non-active portion of therechargeable ICD should be placed proximal to the skin of the patient.In this respect, the non-active portion is placed subcutaneously asclose as possible to the surface of the skin in order to minimize thedistance between charger transmitter/programmer 226 and the inductionantenna (not shown) in the rechargeable ICD. The efficiency at which theinduction antenna can receive energy wirelessly and thus pass on theenergy to recharge the rechargeable battery of the rechargeable ICD isdirectly proportional to the distance between the induction antenna andthe charger transmitter/programmer 226. Charger transmitter/programmer226 may include a lead (not shown) fashioned as a suction cup which canbe placed on the skin of the patient directly above the non-activeportion of the rechargeable ICD. By minimizing the distance between thenon-active portion and the aforementioned lead, efficient wirelessinductive charging of the rechargeable battery of the rechargeable ICDcan be achieved. According to the disclosed technique, the rechargeableICD can be placed in any position in the thoracic region of the patientas well as the ribcage, the back or the belly, however as the distancebetween the non-active portion and the charger transmitter/programmer226 increases, more time and possibly more energy will be required torecharge the rechargeable battery of the rechargeable ICD. An increasein energy may result in an increase in the temperature of the skintissue and cells near the rechargeable ICD, which may cause tissue andcell damage if the temperature increase is too great.

Reference is now made to FIG. 5, which is a schematic illustrationshowing a difference in size between the ICDs of FIGS. 1A, 1B and 1D andthe rechargeable ICD of FIG. 2A, generally referenced 250, constructedan operative in accordance with another embodiment of the disclosedtechnique. A prior art ICD can 252 is shown, having a width 256 and alength 258. Next to prior art ICD can 252 is a rechargeable ICD can 254,constructed according to the disclosed technique. Rechargeable ICD can254 is shown having a width 260 and a length 262. As can be seen,rechargeable ICD can 254 is substantially smaller than prior art ICD can252 due to the smaller size of a rechargeable battery (not shown) usedin rechargeable ICD can 254. This can lead to a more comfortable ICD canin the subcutaneous area in the patient where the ICD can is implanted.

The disclosed technique has been described above as relating to arechargeable ICD having a can and lead design. It is noted that thedisclosed technique can also apply to other ICD designs, such assubcutaneous ICDs which only have a housing or can but no externalleads. In such ICDs, the active section of the can acts as an electrodefor applying a high voltage shock to the heart of a patient. Inaddition, the disclosed technique has been described as having a cancomprising an active section and a non-active section, with the at leastone antenna being placed in the non-active section. According to anotherembodiment of the disclosed technique, the can of the rechargeable ICDis completely active and does not include a non-active section as shownabove in FIG. 2B. In this embodiment, the at least one antenna (notshown) is placed internally within the can which is an active section.The at least one antenna will still be able to transmit and receivesignals through the active section although a higher energy level mightbe needed to transmit and receive signals and for the at least oneantenna to receive enough energy to inductively recharge the battery.According to a further embodiment, the can of the rechargeable ICD iscompletely active and does not include a non-active section as shownabove in FIG. 2B and includes at least one antenna which is placed onthe outer surface of the active can. The at least one antenna coupleswith components inside the active can via a dielectric feed-thru on thesurface of the active can.

Reference is now made to FIG. 6A, which is a schematic illustrationanother rechargeable ICD, generally referenced 280, constructed anoperative in accordance with a further embodiment of the disclosedtechnique. Rechargeable ICD 280 has a general D-shape and includes a can282 and at least one lead 284. Can 282 is a hermetically sealed can. Can282 includes an active section 288 and a non-active section 290. Asshown, active section 288 covers most of the surface area of can 282.Active section 288 can act as an electrode with at least one lead 284 toform an electric shock vector for applying a high voltage shock to theheart (not shown) of a patient. Active section 288 can also act as asensor for sensing electrical activity of the heart. The active areas ofcan 282 are shown by a plurality of arrows 294. Non-active section 290has a substantially circular shape and substantially acts as an antenna(not shown) for transmitting and receiving information wirelessly whilealso receiving RF energy to inductively charge the rechargeable batteryof ICD 280. Non-active section 290 may also house at least one antenna(not shown). The non-active area of can 282 is shown by an arrow 296.Non-active section 290 is insulated electrically from active section 288by an isolator 292. Isolator 292 has a substantially circular shape, canbe made from insulating materials such as glass, ceramic and the likeand electrically insulates non-active section 290 from active section288. Isolator 292 can be a glass metal ceiling. Isolator 292 may includea dielectric feed-thru (not shown) for coupling non-active section 290with active section 288 such that EM energy received by non-activesection 290 can be passed to active section 288 while neverthelesskeeping it electrically insulated from active section 288. Non-activesection 290 may be coupled with any of the internal components of can282, such as at least one high voltage capacitor (not shown), a chargingcircuit (not shown), an electronic circuit (not shown) and arechargeable power source (not shown). Can 282 also includes a leadconnector 286, for coupling at least one lead 284 with the internalcomponents of active section 288. As explained above, active section 288includes all the necessary components for the functioning ofrechargeable ICD 280 such as at least one high voltage capacitor, anelectronic circuit, a charging circuit and a rechargeable power source.Lead connector 286 may be coupled with active section 288 via anotherdielectric feed-thru (not shown).

Reference is now made to FIG. 6B, which is a schematic illustration afurther rechargeable ICD, generally referenced 310, constructed anoperative in accordance with another embodiment of the disclosedtechnique. Rechargeable ICD 310 has a general D-shape and includes a can312 and at least one lead 314. Can 312 is a hermetically sealed can. Can312 includes an active section 318 and a non-active section 316. Asshown, active section 318 and non-active section 316 each substantiallycover about half the surface area of can 312. Both non-active section316 and active section 318 have substantially D-shapes. Active section318 can act as an electrode with at least one lead 314 to form anelectric shock vector for applying a high voltage shock to the heart(not shown) of a patient. Active section 318 can also act as a sensorfor sensing electrical activity of the heart. The active areas of can312 are shown by a plurality of arrows 326 whereas the non-active areasof can 312 are shown by a plurality of arrows 324. Non-active section316 substantially acts as an antenna (not shown) for transmitting andreceiving information wirelessly while also receiving RF energy toinductively charge the rechargeable battery of ICD 310. Non-activesection 316 may also house at least one antenna (not shown). Non-activesection 316 is insulated electrically from active section 318 by anisolator 320. Isolator 320 has a substantially circular shape andseparates the active half of can 312 from the non-active half of can312. The separation of isolator 320 can be along the circumference ofcan 312. The separation of isolator 320 can also substantially dividecan 312 into two, active section 318 and non-active section 316.Isolator 320 can be made from insulating materials such as glass,ceramic and the like and electrically insulates non-active section 316from active section 318. Isolator 320 can be a glass metal ceiling.Isolator 320 may include a dielectric feed-thru (not shown) for couplingnon-active section 316 with active section 318 such that EM energyreceived by non-active section 316 can be passed to active section 318while nevertheless keeping it electrically insulated from active section318. Can 312 also includes a lead connector 322, for coupling at leastone lead 314 with the internal components of active section 318. Asexplained above, active section 318 includes all the necessarycomponents for the functioning of rechargeable ICD 310 such as at leastone high voltage capacitor (not shown), an electronic circuit (notshown), a charging circuit (not shown) and a rechargeable power source(not shown). Non-active section 316 may be coupled with the internalcomponents of can 312 as listed above, such as at least one high voltagecapacitor, a charging circuit, an electronic circuit and a rechargeablepower source. Lead connector 322 may be coupled with active section 318via another dielectric feed-thru (not shown).

It will be appreciated by persons skilled in the art that the disclosedtechnique is not limited to what has been particularly shown anddescribed hereinabove. Rather the scope of the disclosed technique isdefined only by the claims, which follow.

1. Rechargeable implantable cardioverter defibrillator (ICD) comprising:a hermetically sealed can; and at least one lead, coupled with saidhermetically sealed can, said hermetically sealed can comprising: atleast one high voltage capacitor; an electronic circuit, coupled withsaid at least one high voltage capacitor; and a rechargeable battery,coupled with said electronic circuit and said at least one high voltagecapacitor; an outer surface of said hermetically sealed can comprising:an active section; and a non-active section, said non-active sectionbeing electrically insulated from said active section, wherein a surfacearea of said active section acts as at least one of an electrode withsaid at least one lead for forming an electric shock vector for applyinga high voltage shock and a sensor for sensing electrical activity; andwherein a surface area of said non-active section acts as at least oneantenna for transmitting and receiving information wirelessly while alsoreceiving electromagnetic (EM) energy to inductively charge saidrechargeable battery.
 2. The rechargeable ICD according to claim 1,wherein said electronic circuit comprises a processor.
 3. Therechargeable ICD according to claim 1, wherein said electronic circuitcomprises a charging circuit, coupled with said rechargeable battery. 4.The rechargeable ICD according to claim 1, wherein said at least onelead is placed in a location in a patient selected from the listconsisting of: intravascularly; and nonvascularly.
 5. The rechargeableICD according to claim 1, said hermetically sealed can furthercomprising a dielectric feed-thru, for coupling said at least one leadwith at least one of said at least one high voltage capacitor, saidelectronic circuit and said rechargeable battery.
 6. The rechargeableICD according to claim 1, said hermetically sealed can furthercomprising a lead connector, for coupling said at least one lead with atleast one of said at least one high voltage capacitor, said electroniccircuit and said rechargeable battery.
 7. The rechargeable ICD accordingto claim 1, wherein said non-active section is made from an insulatingmaterial selected from the list consisting of: glass; ceramic; andporcelain.
 8. The rechargeable ICD according to claim 1, wherein said atleast one antenna is internal to said non-active section.
 9. Therechargeable ICD according to claim 1, wherein said at least one antennacomprises a transmission antenna and an induction antenna.
 10. Therechargeable ICD according to claim 9, wherein said transmission antennaand said induction antenna are coupled with said electronic circuit andwherein said induction antenna is also coupled with a charging circuitin said active section.
 11. The rechargeable ICD according to claim 10,wherein said induction antenna receives EM energy and wherein saidcharging circuit converts said received EM energy into electrical energyfor inductively recharging said rechargeable battery.
 12. Therechargeable ICD according to claim 9, wherein said transmission antennaonly transmits signals and wherein said induction antenna transmits andreceives signals.
 13. The rechargeable ICD according to claim 1, whereinsaid rechargeable battery is a lithium-ion battery.
 14. The rechargeableICD according to claim 1, wherein said received signals and saidtransmitted signals are wireless protocol signals.
 15. The rechargeableICD according to claim 14, wherein said wireless protocol signals areselected from the list consisting of: Bluetooth®; Bluetooth low energy(BLE®); Wi-Fi®; Medical Implant Communication Service (MICS); MedicalImplant Communication Service Medical Data Service (MICS/MEDS); andMedical Device Radiocommunications Service (MedRadio).
 16. Therechargeable ICD according to claim 1, wherein said at least one antennacan wirelessly transmit signals indicative of a status of saidrechargeable ICD to an external device; and wherein said at least oneantenna can wirelessly receive signals from a programmer for programmingsaid electronic circuit.
 17. The rechargeable ICD according to claim 16,wherein said received signals from said programmer are modulated signalsfor simultaneously recharging said rechargeable battery and programmingsaid electronic circuit. 18.-25. (canceled)
 26. Rechargeable implantablecardioverter defibrillator (ICD) comprising: an active section; and anon-active section, said non-active section being electrically insulatedfrom said active section and forming a hermetically sealed can with saidactive section, said active section comprising: at least one highvoltage capacitor; an electronic circuit, coupled with said at least onehigh voltage capacitor; and a rechargeable battery, coupled with saidelectronic circuit and said at least one high voltage capacitor; whereina surface area of said active section acts as at least one of anelectrode for forming an electric shock vector for applying a highvoltage shock and a sensor for sensing electrical activity; and whereina surface area of said non-active section acts as at least one antennafor transmitting and receiving information wirelessly while alsoreceiving electromagnetic (EM) energy to inductively charge saidrechargeable battery.
 27. Rechargeable implantable cardioverterdefibrillator (ICD) comprising: a hermetically sealed can; and at leastone lead, coupled with said hermetically sealed can, said hermeticallysealed can comprising: at least one high voltage capacitor; anelectronic circuit, coupled with said at least one high voltagecapacitor; a rechargeable battery, coupled with said electronic circuitand said at least one high voltage capacitor; at least one antenna; adielectric feed-thru, wherein said at least one antenna can wirelesslyreceive electromagnetic (EM) energy for inductively charging saidrechargeable battery; wherein said at least one antenna can wirelesslytransmit signals indicative of a status of said rechargeable ICD to anexternal device; wherein said at least one antenna can wirelesslyreceive signals from a programmer for programming said electroniccircuit; and wherein said at least one antenna is placed on an outerelement of said hermetically sealed can and is coupled with saidelectronic circuit and said rechargeable battery via said dielectricfeed-thru.
 28. (canceled)